Wiki percutaneous pinning of lesser toe

[NEOSM507]

Hi

Physician performed closed reduction of lesser toe with percutaneous pinning. I can only find a CPT code to report this in the great toe. We tried to authorize an unlisted procedure, but the carrier is telling me that there is a code for what we did. The only code I can find similar is for the closed reduction of a lesser toe, but the percutaneous pinning is not named in the description.

CPT 28525 states OPEN treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation. This was not OPEN treatment. Unless they consider breaking of the skin with a k-wire to be open treatment.

Any help would be appreciated. Thank you!!

 

[sxcoder1]

28496?

 

[NEOSM507]

It is my understanding that 28496, percutaneous skeletal fixation of fracture of great toe, phalanx or phalanges, with manipulation, means proximal or distal end of great toe, not great toe, and all phalanges on foot. I would love to be wrong about that!

 

[jennybiv]

Take a look at the Coding Tips for CPT 28525 that Encoder supplies:


This CPT includes perc pinning of lesser toes.

Also, the lay description of CPT 28496 is specific to the big toe. So this code would not apply to lesser toes.